Dental Pulse Academy Microbiology

AP PG -30 – Microbiology –Answers

1. Ans. 1, Ananthnarayan 7th ed Pg 591-592 6. Ans. 2, Chatterjee 12th ed pg 31

 ELISA is simple and relatively inexpensive but false positive  Exploratory puncture is one of the most practical methods for
reactions are not uncommon, particularly with sera containing confirming the diagnosis of amboebic liver abscess. The
Rheumatoid factor, antilymphocyte or other antibodies.  aspirated pus may be examined for the demonstration of trophic
 Sera stored for long periods contain nonspecific sticky forms (trophozoites) of E. histolytica.
immunoglobulins.
 False positive results can also occur in hepatic disease.  Aspirations from the center of amoebic liver abscess do not
 ELISA is a screening test and is ideal for screening several show trophozoites, while aspirates from the margins show
samples at a time. trophozoites.
 It is inconvenient for testing single samples quickly.
 A positive result in any one screening test may not be accepted 7. Ans. 3, Harrison 17th ed plg 1106, 1107
without confirmation. EBV causes Thrombocytopenia (not thrombocytosis)
 It was the practice to use for confirmation the western blot test
which was considered the gold standard. 8. Ans. 2, Ananthanarayan 8th ed pg 387-388
MYCOPLASMA:
 As ELISA test can result in false positive results so to remove
them it is confirmed by western blot test. Morphology:
 Smallest free living organism, are prokaryotes.
2. Ans. 3, Ananthnarayn 8th ed Pg 205  Lack cell wall, are bounded by a triple layered unit membrane
that contains sterol (therefore mycoplasmas require sterol for
3. Ans. 3, Ananthanarayan 8th ed Pg 24 growth)
 Their lack of cell wall is associated with cellular pleomorphism
Phase of bacterial and resistance to cell wall-antimicrobial agents, scuhas
Peculiar feature
growth penicillins and cephalosporins ( b-lactam drugs).
Lag phase Maximum size of cell
 Multiplication is by binary fission
Log phase Cells are smaller and stain uniformly
 Non sporing
Stationary phase  Sporulation  Do not possess flagella or fimbria.
 Exotoxin production
 Irregular staining and gram variability  Mycoplasma can be cultivated in fluid or solid media (cell free
Phase of decline Formation of involution forms media).

4. Ans. 1, Ananthnarayanan 7th ed Pg 267 9. Ans. 4, Harrison 17th ed Pg 901

Bacteroids are the most common anaerobes isolated from Botulinum toxin affects:
clinical specimens. They are non-sporing, non motile, strict  Neuromuscular junction
anerobes, usually very pleomorphic, appearing as slender rods,  Post ganglionic parasympathetic nerve endings
branching forms or coccobacilli, seen singly, in pairs or in short  Peripheral ganglia
chains. B.fragilis is the most frequent of the non sporing
anerobes isolated from clinical specimens. Clinically important The central nervous system is not involved
bacteroides spp. are essentially all resistant to penicillin. Failures of
therapy are common when documented bacteroids (especially 10. Ans. 1, Ananthanarayana 8th ed.pg.216 & 217
B.fragilis) infection is treated with penicillin or first generation Streptococcus mutans belong to viridans streptococci and is an
cephalosporins. important cause of dental caries.

5. Ans. 3, 11. Ans. 1, Ananthanarayana 8th ed Pg 97-98

IgG is the major serum immunoglobulin, constituting about 80
percent of the total. IgE is the least common serum immunoglobulin.

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Dental Pulse Academy Microbiology
12. Ans. 3, Ananthnarayanan 7th ed Pg 160  Reaction is reversible  Agglutination injurious antigen,
Type I reactions (IgE dependant) are of two types:  Binding is non  Lysis of cells or to tissue
 Anaphylaxis -is acute, potentially fatal and systemic. covalent  Killing of live antigens damage
 Atopy -is chronic or recurrent, non-fatal and typically localized.  Van der waals  Complement fixation
 Ionic (Electrostatic)  Neutralization of toxin
Type 1 hypersensitivity can be further classified into an immediate
and late-phase reaction. The immediate hypersensitivity reaction  Hydrogen  Immobilization of toxin
occurs minutes after exposure and includes release of vasoactive  Firm covalent bonding motile organisms
amines and lipid mediators, whereas the late-phase reaction occurs does not occur  Enhancement of
24 hours after exposure and includes the release of cytokines phagocytosis

Overview of mediators released by mast cells in type 1 17. Ans. 2, Ananthnarayan 8th ed Pg 572-573, Robbins 7th ed pg
hypersensitivity, and their actions: 252
 Histamine
18. Ans. 3, Anantnarayana 8th ed Pg 381
Vasodilation and  PAF
Days to week after the tick bite, hematogenous dissemination to
increased  Leukotriene C4 , D4 and E4 secondary sites (like joints, heart eye, nervous system) takes place.
permeability  Prostaglandin D2 If untreated, the bacteria may persist in the body for months or even
 Neutral proteases years, despite the production of anti borrelia burgodorferi antibodies
 Histamine by the immune system.
Smooth muscle  PAF 19. Ans. 1, Harrison 17thed Pg 1245, 1246
spasm  Leukotriene C4, D4 and E4 Caseation necrosis and calcification may mimic tuberculosis
 Prostaglandin About other options:
 Cytokines (e.g. chemokines and TNF)  Culture is the preferred method for diagnosis.
Leukocyte  Leukotriene B4  Spores are the infective form and infection is acquired by
extravasation  Chemotactic factors for neutrophils and inhalation of spores.
eosinophils  Histoplasma infec tion never transmits from man to man.

13. Ans. 2, Robbins 7th ed Pg 206 20. Ans. 2, Harrison 17thed Pg 1939
Type I hypersensitivity (Immediate hypersensitivity)
 It is a rapidly developing immunological reaction occurring Carrier
within minutes after the combination of an antigen with antibody Present  HBV
bound to mast cells in individuals previously sensitized to the  HCV
antigen.  HDV
 Immediate hypersensitivity reactions are mediated by Ig E, but
Absent  HAV
T and B cells play important roles in the development of these
antibodies.  HEV
 Type I reaction requires prior sensitization to a specific antigen
(allergen) Remember
 Most exposures occur either by inhalation (respiratory route) or Non-A Non-B hepatitis is HCV.
ingestion (GIT) of antigen.
21. Ans. 1, Harrison 17th ed Pg 1941; 16th ed Pg 1829
14. Ans. 3, Check Explanation Below Parenterally transmitted hepatitis virus
 Hepatitis B
Methods employed for cultivation/ isolation of viruses may  Hepatitis C
include  Hepatitis D
Tissue culture/ Cell Embryonated eggs Animal inoculation  Hepatitis G
culture  Hepatitis A
Most important for Embryonated egg  Earliest method  Hepatitis B
cultivation of viruses. provides several sites for cultivation of
Hepatitis E is feco-oral transmitted virus
Tissue provide the for cultivation of viruses.
cellular environment that viruses.  Infants suckling 22. Ans. 2, Check Explanation Below
is essential for growth of Inoculation on CAM mice are the most
these obligate (chorioallantoic widely employed Parasites causing malabsorption in adults
intracellular parasites medium) animals in  Giardia lamblia
They include Inoculation in to virology.  H . Nana
 organ culture. amniotic sac.
 Growth of viruses
Inoculation in to  Cyclospora
 cell culture. may be indicated
allantoic cavity.  E . histolytica
 Explant culture by death, disease
Yolk sac inoculation.  Strongyloides
or visible lesion.
Parasites associated with malabsorption in children
15. Ans. 2, Ananthnarayan 8thed Pg 570  Giardia lamblia
The genome in HIV is diploid, composed of two identical single  Cryptosporidium
stranded positive sense RNA copies  H . nana
16. Ans. 4, Ananthnarayan 8th ed Pg 102  Isospora belli
Antigen antibody reaction is a reaction that occurs when an antigen  Ancyclostoma duodenale
combines with a corresponding antibody to produce a immune  Entamoeba histolytica
complex. The reactions between antigen and antibodies occur in
three stages: 23. Ans. 1, Harrison 17th ed Pg 895
The important clues in this question are- Organisms are gram
Antigen antibody reaction positive coccobacilli, Organisms are pleomorphic and occurring in
Primary stage Secondary stage Tertiary stage short chains, there is tumbling motility. All these are the features of
 Initial interaction  Leading to Chain of reactions Listeria monocytogens.
without any visible demonstrable events that lead to
neutralization or 24. Ans. 1, Ananthnarayan 7th ed Pg 177
effects  Precipitation
destruction of

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Dental Pulse Academy Microbiology
25. Ans. 3, Ananthanarayan 8th ed pg 302  Pus is chocolate coloured, classically called as anchovy-sauce,
contains dead liver cells, RBCs, WBCs, necrotic material. Pus
Darting motility → V.cholera may be green due to bile admixture.
Stately motility → Clostridia  Often secondary infection by E. coli, staph, strepto may occur
Tumbling motility → Listeria (at 20-25oC and thus may present with features of pyogenic liver abscess.
Lashing motility → Borrelia
MICROSCOPIC EXAMINATION OF PUS:
Cork screw motility → T.pallidum
On microscopic examination the pus may show deformed of dead
Gliding motility → Mycoplasma hepatocytes, debris, RBCs and a few polymorphs. The trophozoites
Swarming → Proteus mirabilis, P.vulgaris, of the Entamoeba Histolytica are usually present in the wall of the
B.cereus, Cl.tetani abscess. Hence it is not surprising that many authors report their
total absence or very low incidence, on examination of the pus.
26. Ans. 4, Ananthanarayana 8th ed.pg-21 However when the pus is examined carefully, they are found in 15-
Fimbriae function as organs of adhesion, helping the cells to adhere 25% of the cases.
firmly to particles of various kind. A specially type of fimbriae are
sex pilli. These are found on male bacteria and help in conjugation 35. Ans. 4, Harrison 17th ed Pg 2060
by forming conjugation tube through which genetic material is Wiskott-Aldrich syndrome:
transferred from the donor to the recipient cell.  X-linked recessive disease characterized by classical triad of
 Organ of adhesion → Fimbriae (Pilli) eczema, thrombocytopenia and recurrent infections.
 Organ of locomotion → Flagella  IgM is low, while IgA and IgG are normal and IgE is increased.
 There is no progressive secondary depletion of T lymphocytes
27. Ans. 2, Ananthanarayan 8th ed pg 472
in the peripheral blood and T-cell zones of lymph nodes.
28. Ans. 4, Ananthanarayana 8th ed.pg-207  B-cells are normal
Str. Pyogenes forms several exotoxins and enzymes which  Patients are unable to make antibodies against polysaccharide
contribute to its virulence, but M protein is the most important of antigens, response to protein antigen is impaired late in the
these. course of disease.
 The only treatment is bone marrow transplantation.
29. Ans. 4, Ananthanarayan 8th ed Pg 258
36. Ans. 1, Ananthnarayan 8th ed Pg 21
30. Ans. 3, European Journal of Immunology 2006 Capsule is sharply defined structure around the cell surface. When it
 Isotype switching is a biological mechanism that changes a B is loose and undemarcated, it is called slime layer. Capsule serves
cells production of antibody from one class to another, for as source of nutrition. It contains virulence factors and makes the
example IgM is primary response to IgG in secondary bacteria resistant to phagocytosis.
response.
37. Ans. 4, Ananthanarayan 8th ed Pg 544
 During this process, the constant region portion of the antibody
heavy chain is changed, but the variable region of the heavy 38. Ans. 2, Harrison 17th ed Pg 1939
chain stays the same.
 Since the variable region does not change, class switching 39. Ans. 2, Harrison 17th ed Pg 1043 & 16th ed Pg 981
does not affect antigen specificity. Painless indurated ulcer with non-tender inguinal lymphadenopathy
points towards the diagnosis of syphilis.
 Instead, the antibody retains affinity for the same antigen, but
can interact with different effector molecules. 40. Ans. 4, Rajesh Karyakarte Pg 140
Eggs of Opisthorcis viverni have size very much less than 100 m
Note: No option amongst the given four is completely correct.
Isotype variation is due to variations in amino-acid sequences in the Parasite Egg size
constant region or carboxyterminal of heavy chains (not in both Fasciola gigantica 190 x 100 micron
heavy and light chains) Echinostoma iliocanum 100 x 70 micron
Gastodiscoides hominis 150 x 70 micron
31. Ans. 3, Harrison 17th ed Pg 789,790 Opisthorcis viverni <30 x 15 micron
Most common cause of prosthetic valve endocarditis upto 12 months
is coagulase negative Staphylococci (Staph. epidermis) 41. Ans. 1, Harrison 17th ed Pg 1117
Warts are caused by Human papillomavirus (HPV)
Virus Modes of transmission
42. Ans. 4, Ananthnarayan 8th ed Pg 458-459
Hepatitis A Feco-oral Phage typing is done for
Hepatitis B Percutaneous, perinatal, sexual  Salmonella
Hepatitis C Percutaneous  V. cholerae
Hepatitis D Percutaneous, perinatal, sexual  Staph aureus
Hepatitis E Feco-oral  Bacillus anthracis
32. Ans. 1, Ananthanarayan 8th ed Pg 408 & 7th ed Pg 416 43. Ans. 4, Ananthanarayan 8th ed Pg 417

33. Ans. 3, Chatterjee Parasitology 12th ed Pg 127 44. Ans. 1, Harrison 17th ed Pg 1009
Cell mediated immunity confers protection against M. tuberculosis,
34. Ans. 2, Jayaram Paniker 6th ed Pg 27 while humoral immunity has no defined role in protection. Two types
Pathology of cells are essential 1.Macrophages 2. T cells (mainly CD4+).
 Initially from infected recto-sigmoid or ileocaecal region, 45. Ans. 1, Ananthnarayan 8th ed Pg 272
amoebic trophozoites reaches the liver through portal veins The Enterobacteriaceae are a large, heterogenous group of gram-
causing amoebic hepatitis, may be in the form of micro- negative rods whose natural habitat is the intestinal tract of humans
abscesses all over the liver. This might resolve on its own or and animals.
with antiamoebic drugs, but often leads to a localized amoebic
liver abscess.  Escherichia  Morganella
 It may be single large abscess or multiple, and may involve  Edwardsiella  Providencia
both lobes.
 Citrobacter  Klebsiella
 Amoebic liver abscess is more common in right posterior-
 Salmonella  Enterobacter
superior region because the portal vein is in direct continuation
with the right tributary. It can be multiloculated.  Shigella  Hafnia
 Erwinia  Serratia

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Dental Pulse Academy Microbiology
 Proteus  IgG1 - 65%
 IgG2 - 23%
46. Ans. 3, Ananthanarayan 8th ed Pg 411  IgG3 - 8%
 IgG4 - 4%
47. Ans. 3, Ananthanarayan 8th ed Pg 604
Remember:
48. Ans. 3, Greenwood 16th ed.pg-81
 IgG1, IgG3 and sometimes IgG2 activate classical complement
Povidone iodine (Betadine) is less irritant and cause less staining.
pathway.
Aqueous and alcohol-based povidone iodine preparations are widely
used in skin disinfection including preoperative preparation of the  IgG4 activities alternate complement pathway
skin.  Passively administered IgG suppresses the homologous
antibody synthesis by a feedback process. This property is
49. Ans. 3, Ananthanarayan 8th ed plg 520 utilized in the isoimmunization of women by the administration
of anti-Rh(D) IgG during delivery.
Diseases transmitted by Ticks
Hard tick Soft tick 56. Ans. 3, Jawetz 23rd ed Pg 60
↓ ↓ Chlorine has bactericidal, virucidal and at higher concentration
sporicidal effect.
 KFD Q fever
o Tick typhus Relapsing fever Chlorine is commonly used for
o Viral encephalitis  KFD  disinfection of water by chlorine tablets or sodium hypochlorite
o Viral fever  disinfection of equipment soiled with blood by sodium
o Viral hemorrhagic fever hypochlorite.
 Tularemia
o Tick paralysis 57. Ans. 2, Greenwood 16th ed Pg 583
o Human babesiosis C. neoformans is best demonstrated in CSF by direct microscopy.
Mosquito-borne disease The capsule is seen as a clear halo around the yeast cells in
Anopheles Culex Aedes Monsonoides unstained wet preparations of CSF mixed with a drop of India ink or
Malaria Filaria (Bancroftian) Yellow fever Brugian nigrosine. Methamine silver stain would be the best choice for a
Japanese encephalitis Dengue filariasis tissue sample.
West Nile fever Chikungunya Chikungunya
Viral hepatitis Rift valley fever Laboratory diagnosis of C. neoformans
↓
50. Ans. 2, Ananthanarayana 8th ed Pg 147 ↓ ↓ ↓
Direct Serology Culture
51. Ans. 1, Harrison 17th ed Pg 790 microscopy
 Most common cause of native valve endocarditis is Staph,
 Unstained wet  The most useful serological  Cryptococcus
aureus
preparations of test is LPA test for detection can be easily
 Most common cause of early onset prosthetic valve CSF mixed with of Lipopolysacharide antigen cultured from
endocarditis (<12 mts & 2-12 mts) is coagulase negative a drop of India of cyptococcus. This is highly the CSF, on
staphylococci Ink or nigrosine: sensitivity and specific, for sabarouds
 Most common cause of late onset prosthetic valve endocarditis demonstrate the diagnosis and gives better agar.
(> 12 mts) is Streptococci (e.g. streptococcus viridans) capsule of results than direct microscopy  C.neofermans
 Most common cause of endocarditis in I.V. drug abusers is C.neoformans and culture. is
Staph aures. as a clear halo. distinguished
 Stain such as Remember: form other
52. Ans. 2, Ananthanarayan 8th ed Pg 578 alcian blue and  Test for serum antibody re yeasts by:
Window period: It takes 2-8 weeks to months for antibodies to mucicarmine positive in less than 50% of  Ability to grow
appear after infection. This period, from infection to appearance of stain the proven cases of cryptococcal at 370C
antibodies, is called as window period. During this period patients capsular meningitis, since antibodies  Ability to
are seronegative i.e., serological tests (ELISA and Western blot) are material and are neutralized rapidly, by the
negative. The individual may be highly infectious during this period. hydrolyse
enable large amount of capsular urea
53. Ans. 4, Park 19th ed Pg 622 identification of antigen released during  Lack of
organism and evolution of infection fermentative
54. Ans. 3, Ananthanarayan 8thed Pg 207-208, 7th ed Pg 206 differentiation (antibodies are not ability.
Antigen cross-reactivity from protective). Antibodies may
Various streptococcal components (specially strep. pyogenes) H.capsulatum subsequently reappear, in
exhibit antigenic cross reaction with different tissues of the human and patients after successful
body. The important ones are: B.dermatides. treatment.
Streptococcal component Human tissue
Capsular hyaluronic acid Synovial fluid
Cell wall protein Myocardium 58. Ans. 2, Harrison 17th ed Pg 879
The carbapenem imipenem has excellent activity against methicillin
Group A carbohydrate Cardiac valves
sensitive S. aureus but not M.R.S.A.
Cytoplasmic membrane antigen Vascular intima
Peptidoglycans Skin antigens
59. Ans. 4, Ananthanarayan 8th ed Pg 198
This antigen cross reactivity is responsible for the production of Gastroenteritis presenting within 4-6 hrs of consumption of
cross reacting antibodies i.e. antibodies are formed against sandwitches confirms the diagnosis of staphylococcal food
streptococcal antigens but they damage host tissue antigens poisoning. The only other cause of food poisoning presenting within
because of similarity between streptococcal antigens and human 4-6 hrs id bacillus cereus but it is not given in the option
tissue antigens antigenic cross reactivity
60. Ans. 4, Harrison 17th ed Pg 1215
Antigenic cross reactivity is responsible for nonsuppurative Subacute sclerosing panencephalitis (SSPE) is a rare complication
manifestations, e.g. carditis of measles, which develops many years after the initial
infection. The most common complications are: measles- associated
55. Ans. 1, Harrison 17th ed Pg 2036, Ananthnarayan 8th ed Pg 98 diarrhoea, pneumonia and otitis media.
Four subclasses of IgG have been recognized, IgG 1 being found in
greatest amount and IgG4 the least. 61. Ans. 2, Ananthanarayan 8thed Pg 395 & 7th ed Pg 403

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Dental Pulse Academy
62. Ans. 2, Harrison 17thed Pg 1278
Flask-shaped ulcer in a patient of GI bleed suggests amebiasis
(amoebic dysentery).
Drug therapy for amoebiasis
 Asymptoamtic carrier - Luminal agents (Iodoquinol,
Paromomycine). Diloxanide furoate is the Luminal agent of
choice.
 Acute colitis - Metronidazole + Luminal agent
 Liver abscess - Metronidazole or tinidazole or ornidazole +
Luminal agent.
63. Ans. 2, An atlas of differential diagnosis in HIV disease by
Lipman, Gluck and Johnson 1st (1995) Pg 30
Herpes simplex (in the developed world) and chancroid (in Africa)
are the most common cause of genital ulceration in HIV infected
patients.
64. Ans. 1, Harrison 17th ed Pg 1040
Painless indurated ulcer with everted margins, history of sexual
exposure and lack of systemic symptoms favours the diagnosis of
syphilis.
65. Ans. 4, Ananthanarayana 8th ed Pg 601
The periodic acid Schiff (PAS) and methenamine silver stains are
valuable methods for the demonstration of fungal elements in tissue
sections.
66. Ans. 1, Harrison 17th ed Pg 1052, 1053, Anantnarayana 8th ed
Pg 387
67. Ans. 3, Harrison 17th ed Pg 969
Elevated levels of circulating tumor necrosis factor (TNF) have been
demonstrated in ENL, thus TNF may play a central role in the
pathobiology of this syndrome.
68. Ans. 3, Ananthanarayana 8th ed Pg 348
Man to man spread does not ordinarily occur but very rarely
transmission has been reported through placenta, breast feeding
and sex. Human brucellosis is a zoonosis, acquired from animal
directly or indirectly.
69. Ans. 4, Jayaram Panikar 6th ed Pg 45
70. Ans. 1, Ananthanarayan 8th ed Pg 163
71. Ans. 2, Ananthanarayn 8th ed Pg 218, 219
Streptococci have been categorised into three varieties based on
their growth in 5% blood agar pour plate cultures:-
Streptococci
Alpha Beta Gamma
Greenish discolouration with Colourless zone of No
partial hemolysis around complete hemolysis hemolysis
colonies Eg: Eg:
Eg: Str- pyogenes Enterococci
Str. Pneumonia Str. agalactiae
Str. viridans Str. equisimilis
In the question isolated organism is showing alpha hemolysis.
Streptococci causing Alpha-hemolysis are
 Str. pneumoniae
 Viridans streptococci Str. mutans, Str. sanguis, Str. salivarius,
Str. mitis
 Some strains of enterococci
Viridans streptococci and enterococci usually do not cause
respiratory tract infection. Now we are left with pneumococci only.
The fact that pneumococcus infection is predisposed by old age also
favours pneumococci as causative organism in this question. So,
most likely the infective organism in this question is pneumococcus
which iscatalase positive, bile soluble and occurs in pairs
(diplococci) with broad ends in opposition presenting a flame
shaped or lanceolate appearance.
72. Ans. 2, Ananthanarayan 8th ed pg 428, 435
Hemadsorption
When hemagglutinating viruses grow in cell cultures, their presence
can be indicated by the addition of guinea pig erythrocyte to culture.
If the viruses are multiplying in the culture, the erythrocytes will
adsorb on to the surface of cells. This is kinown as hemadsorption
30th Session AP PG – 11.06.2016
Microbiology
Viruses causing hemagglutination are:
 Influenza Virus Measles Tubella Coxsackie Virus Rhino Virus
Fabies
 Parainfluenza virus Toga Virus Entero Virus Echo Virus Reo
Virus.
73. Ans. 1, ENT Dhingra 3rd ed Pg 241
 Many different species of fungi are found to involve the
paranasal sinuses, the more common being the Aspergillus,
Alternaria, Mucor or Rhizopus.
 Most common type of fungal infection of nose and paranasal
sinuses are due to Aspergillus, Aspergillus fumigatus,
Aspergillus niger and Aspergillus flavus are most frequent
offenders.
74. Ans. 4, Park 20thed Pg 202, 203
Cholera exotoxin (enterotoxin) affects only intestinal epithelial cells.
Cholera exotoxin has no effects on any other tissues except
intestinal epithelial cells. There is no evidence the V. cholera
invades any tissue nor the enterotoxin to have any direct effect on
any organ other than the small intestine.
The human is the only reservoir of cholera infection, which may
be a case or carrier. There is no known animal reservoir.
 V. cholera are killed within a few seconds by boiling
 V. cholera can survive in ice cold weather for 2-4 weeks.
They remain in ice for 4-6 weeks or longer.
75. Ans. 4, Harrisons 17th ed Pg 906
Typical food poisoning strains produce heat-resistant spores that
can survive boiling for several hours, where as the spores of the
type A strains that cause gas gangrene are inactivated within a few
minutes by boiling.
 Cl. Perfringens is a normal inhabitant of the large intestines of
human beings and animals. It is found in the feces and
contaminates the skin of the perineum, buttocks, and thighs.
Type A predominates in fecal flora of humans as well as in soil.
 The alpha toxin is produced by all types of Cl. perfringens and
most abundantly by type A strains. This is the most important
toxin biologically and is responsible for profound toxemia of gas
gangrene.
 Some 80% of the cases of gas gangrene is usually caused by
C. perfringens, while C. novyi, C. septicum and C. histolyticum
cause most of the remaining cases.
Remember
 Cl. ramosum is the most abundant colonic flora among
clostridia followed by Cl. perfringens.
76. Ans. 4, Ananthanarayan 8thed Pg 40
 Nutrient broth is a basal medium (simple medium)
 It consists of peptone, meat extract, sodium chloride and water.
 Nutrient agar, made by adding 2% agar to nutrient broth is the
simplest and most common medium in routine diagnostic
laboratories
About other options:
 Agar has virtually no nutritive value and is not affected by the
growth of bacteria
 Chocolate medium is an enriched medium
 Addition of selective substances in a solid medium is called
selective medium
 Addition of selective substances in a liquid medium is called
enrichment medium.
77. Ans. 3, Ananthanarayan 8th ed Pg 36
2% Glutaraldehyde is known as CIDEX
78. Ans. 3, Harrison 17th ed Pg 1201
Needle stick injury is the most common cause of HIV infection
among health care workers. The guidelines for post-exposure
prophylaxis of HIV are
 For routine exposures: A combination of two nucleoside
reverse transcriptase inhibitors for 4 weeks.
 For high risk or complicated exposures: Inspite of the
guidelines regimen B is given for all types of exposure.
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Dental Pulse Academy Microbiology
79. Ans. 2, Robbins 7th ed Pg 67; Harrison 17th ed Pg 2065, 2066 88. Ans. 3, Ananthnarayan 18th ed Pg 98 (table 12.1); Harrison 17th
 This patient has: Recurrent facial / oropharyngeal / laryngeal ed Pg 2036
edema: Low C4: Normal C3 and Factor 3 IgG is the major serum immunoglobulin (80%) which is distributed
 All these features suggest the diagnosis of Hereditary equally between the intravascular and extravascular compartments.
Angioneurotic edema which occurs due to the deficiency of C1 It contains less carbohydrate than other immunoglobulins and has
inhibitor (a regulatory protein in complement pathways). maximum half-life. It is the predominant antibody in secondary
antibody response. Four subclasses of IgG are there with IgG 1, is
80. Ans. 2, Ananthanarayan 8th ed Pg 36 found in greatest amount and IgG4 in least amount. IgG is the only
2% Glutaradehyde (cidex) is an aldehyde disinfectant with a broad maternal immunoglobulin, that is normally transported across the
spectrum of action against bacteria, fungi, viruses, as well as spores placenta and provides natural passive immunity in the newborn
(slow action). It is most often used for equipment such as
endoscopes that cannot be sterilized or disinfected by heat 89. Ans. 2, Harrison 17th ed Pg 1334, 1335
(cytoscopes/bronchoscopes). Clonorchis sinesis is a trematode. It is also known as liver luke. Man
is definitive host for clonorchis and snail is the secondary host.
81. Ans. 3, Jawetz 23rd ed Pg 313, 295 Chronic infection or repeated infection is associated with
Neisseria meningitides, salmonella typhi and Legionella manifestations such as:
pneumophilia are all known to survive intracellularly. Streptococcus  Cholangitis
pyogenes is the single best answer of exclusion here.
 Cholangiohepatitis
Intracellular nature  Biliary obstruction (Biliary obstruction causes increase in
↓ alkaline phosphatase)
Legionella pneumophilia Neisseria Salmonella typhii
meningitidis Also know
Clonorchis sinesis infection is associated with cholangiocarcinoma.
L. pneumophilia readily  Neisseria typically The ability to resist
enters and grows within are found intracellular killing
human alveolar 90. Ans. 1, Ananthnarayan 8th ed Pg 543-544
associated with or and to multiply IgM anti-HBc antibody is the marker of acute or recent HBV infection
macrophages ad inside within polymorphs
monocytes ad is not polymorpho- and macrophages
effectively killed by is a measure of 91. Ans. 3, Ananthnarayan 8th ed Pg 540
nuclear cells
polymorphonuclear  The genome of HBV is made of circular DNA, but it is unusual
 Meningococci are their virulence. because the DNA is not fully double stranded -> one of the
leukocytes. invariably found in strands is incomplete and another is complete -> partially
the spinal fluid double stranded DNA.
both free and
within the  There are four known genes encoded by genome -> C, X, P, S.
leucocytes
92. Ans. 3, Chatterjee 12th ed Pg 82
82. Ans. 4, Harrison 17th ed Pg 2021 All stages of schizoints in peripheral smear, yellowish brown pigment
and 14-20 merozoites suggest the diagnosis of P. vivax malaria.
Surface antigen Distribution
CD45 → All leukocytes Colour of pigment No. of merozoites per schizonts
CD45 RA → Medullary T cells i.e., nave T cells  P . vivax Yellow  P . vivax 14-20
CD45 RB → All leukocytes brown  P . ovale 6-12
CD45 RC → Subset, T medullary thymocytes nave T  P . ovale Dark  P . malariae 6-12
CD45 RO → Subset T. Cortical thymocytes Memory brown  P . falciparum 8-32 (very rare In
 P .malariae Brown peripheral blood)
83. Ans. 1, Ananthnarayan 8th ed Pg 546 black
Hepatitis E virus is also known as enterically transmitted non-A non-  P . falciparum
B (NANB) virus or epidemic NANB. It is classified in the genus Black
Herpes virus under the family caliciviridae. It is a RNA virus with
single-stranded positive sense RNA. It is transmitted by fecal-oral
route. 93. Ans. 1, Ananthnarayan 8th ed Pg 608

84. Ans. 1, Harrison 17th ed Pg 1932 94. Ans. 2, Ananthanarayan 8th ed Pg 133
 HAV can be cultivated reproducibly in vitro. HLA complex
 HAV is the only cultivable hepatitis virus It consists of three separate clusters of genes :

85. Ans. 3, Harrison 17th ed Pg 1257 HLA Complex [MHC complex]

 Septate hyphae with acute branching - Aspergillus Class I Class II Class III
 Non septate hyphae with obtuse branching Rhizopus/mucor  Comprising A, B and D region DR, DQ, DP Complement
C loci  Responsible for region encodes
86. Ans. 4, Ananthnarayan 8th ed Pg 485, 486  Responsible for - Graft versus host  C2 & C4
Lab diagnoses of polio are: - Graft rejection response  Properdin
 Virus isolation in tissue culture is the best method for specific - Cell mediated cytolysis - Mixed leucocyte factor B
diagnosis.  Found on the surface reaction  Heat shock
 Specimens -> Blood, CSF, Throat swab, Feces. of all nucleated cells  Found only on protein
 Primary monkey kidney cultures are used. and platelets cells of the  TNF Alpha
 Serodiagnosis is less often employed. immune system and Beta

87. Ans. 3, Harrison 17 ed Pg 1185

 The majority of cases of CMV retinitis occur in patients with
CD4+T cell count < 50/ml
 It is most common severe ocular complication of AIDS (But
most common abnormal finding in AIDS is cotton-wool spots
unrelated to CMV retinitis).
 Usually bilateral affecting one eye more than other.
 Varicella zoster and herpes simplex cause acute retinal
necrosis syndrome or progressive outer retinal necrosis
(PORN) in AIDS.
95. Ans. 2, Jawetz 23rd ed pg 418
The Parvotirus B-19 is difficult to grow. Virus isolation is not used to
detect infection.
Abut other options:
 Herpes virus grows in a variety of primary and continuous cell
cultures
 Adenoviruses grow in tissue cultures.
 Papoviruses can be grown in tissue cultures

30th Session AP PG – 11.06.2016 6

Dental Pulse Academy Microbiology
96. Ans. 1, Ananthanarayana 8th ed.pg-198 Active subunit of cholera toxin upregulates adenyl cyclase activity by
Virulence factors of staphylococcus aureus: causing irreversible ADP ribosylation of GTP binding regulatory
 There are numerous virulence factors responsible for protein of adenyl cyclase.
pathogenicity of staph aureus, but the most consistent
105. Ans. 4, Ananthanarayan 8th ed Pg 245
association of virulence is production of coagulase and to a
lesser extent, fermentation of mannitol. 106. Ans. 4, Ananthanarayan 8th ed Pg 131
 Coagulase causes activation of prothrombin and leads to fibrin
formation around the bacteria, protecting the bacteria from Mononuclear macrophages
phagocytosis. Blood macrophages → Monocytes
Tissue macrophages → Histocytes
97. Ans. 4, Wintrobes clinical hematology 11th ed Pg. 4145 Lung→ Alveolar macrophages
Immunological markers commonly used to detect myeloid Brain→ Microglia
lineage; - Liver→ Kupffer cells
 CD13 Bone→ Osteoclasts
 CD33 Kidney→ Mesangial cells
 CD11b
 CD15 107. Ans. 2, Check Explanation Below
 CD4  Intraspecies competition-competition within a single population
 CD117  Interspecies competition-is between two or more different
 cMPO (Lineage specific) population.

In the myeloid lineage the most useful antigens for recognizing
myeloblasts include CD 13, CD33, CD117 and cMPO.
98. Ans. 3, Chatterjee 12th ed pg 15
 The trophozoites of E. histolytica engulf red blood cells,
bacteria, yeast and other debris. The presence of red blood
cells in the cytoplasm (erythrophagocytosis) is diagnostic of E.
histolytica as it is the only intestinal amoeba to exhibit this
characteristic.
 Nuclear membrane is lined with a single layer of uniformly
distributed fine chromatin granules. Karyosome is central in
position (not eccentric)
99. Ans. 4, check explanation below
 Paramyxoviruses have negative sense single stranded RNA.
 The enevelop or outer covering of viruses is derived from the
host cell membrane when the progeny virus is released by
budding Anaanthanarayan 7th ed pg.431
 Some paramyxoviruses synthesize their nucleic acid (replicate)
in nucleus also.
 Paramyxoviruses are responsible for a major part of acute
respiratory infection.
100. Ans. 2, Ananthanarayan 8th ed plg 296,297
The antigen used in widal test are:
 H and O antigen of S. typhi
 H antigen of S.paratyphi A & B.
 As paratyphoid O antigens cross react with the S. typhi O
antigen, it is not employed in widal test.
 The H antigen is strongly immunogenic and induce antibody
formation rapidly and in high titres following infection or
immunization. H agglutinins persist longer than O agglutinins.
101. Ans. 4,
102. Ans. 1, Harrison 17th ed Pg 2030
There are four pathways of complementary system:
 The classical activation pathway activated by antigen / antibody
immune complexes.
 The mannose binding lectin activation pathway by microbes
with mannose terminal groups.
 The alternative activation pathway activated by microbes or
tumor cells.
 The terminal pathway that is common to first three pathways
and leads to the membrane attack complex that lyses cells.
103. Ans. 3, Anantharayan 8th ed Pg 243, 245
Mc Fadyeans reaction is used for the presumptive diagnosis of
anthrax. History of skinning a dead animal, development of pustule,
the presence of gram (+)ve bacilli in long chains with positive Mc
Fadyeans reaction are suggestive of anthrax caused by Bacillus
anthracis
104. Ans. 1, Harrisons 16th ed Pg 910, 911
108. Ans. 3, Harrison 17th ed pg 1935
CHRONIC HBV INFECTION
1. Replicative stage (early)
 HBV DNA is found both in serum and hepatocyte nuclei, where
it is present in free or episomal form.
 HBe Ag)+) ve
 Patient has high infectivity
2. Non-replicative stage
 HBV DNA is present only in hepatocyte nuclei, integrated into
the host genome
 Patient has low ineffectivity.
 HBe Ag → Qualitative marker of replication
 HBV DNA → Quantitative marker of replication.
109. Ans. 4,
110. Ans. 1, Ananthnarayan 7th ed Pg 160
This is an example of immediate hypersensitivity also known as type
I, anaphylactic or IgE dependent hypersensitivity.
Includes
 Local: Eczema, Hay fever, Asthma (Atopy)
 Systemic: Anaphylaxis
Examples
 Theobald smith phenomenon. This is anaphylaxis in guinea
pigs
 PK reaction (Prusintz Kunster) demonstrate that IgE is
homocytotropic i.e. species specific.
 Casonis test: Immediate type (IgE) hypersensitivity
111. Ans. 1, Harrison 17th ed pg 1166
Plasma level HIV RNA can be measured by reverse transcriptase
polymerase chain reaction. (RT-PCR) or branches DNA assay (b
DNA)
Other markers of HIV infection:
 P24 antigen
 Double standard DNA
112. Ans. 3, Harrison 17th ed Pg 931
Buffered charcoal, yeast extract (BCYE) agar is a selective media
for legionella. Fever, chest pain and dry cough in an elderly patient
with culture positive on charcoal yeast medium suggest the
diagnosis of legionella infection.
113. Ans. 1, Harrison 17th ed Pg 959, 960
Non-typhoidal Salmonellosis (NTS)
It is the most common type of salmonellosis (more common than
typhoidal salmonellosis)
Common NTS species are
 S.enteritidis
 S.typhimurium

30th Session AP PG – 11.06.2016 7

Dental Pulse Academy
 S.heidelburg
 S. Newport
 S.hadar
Unlike typhoid Salmonella (S. Paratyphi), where only reservoir is
human; non-typhoidal salmonella can be acquired from multiple
animal reservoirs.
114. Ans. 4, Ananthanarayana 8th ed.pg-234
Toxigenicity of diphtheria is not due to chromosomal change, it is
phasae mediated.
115. Ans. 1, Refer explanation below
Most common source of infection of staph. Aureus infections do so
with their own colonizing strains. Most common route of infection is
skin.
116. Ans. 2, Murrays Micro 7th ed Pg 157
Ethylene oxide is typically used to sterilize moisture and heat
sensitive instruments. It is effective against all types of
microorganisms including spores. During ethylene oxide gas
sterilization there are two types of cycle: - i) cold cycle, ii) warm
cycle
In ethylene oxide sterilization
 Cold cycle operates at → 37+ 5 degrees C
 Warm cycle operates at → 54+ 5 degrees C
117. Ans. 2, Ananthnarayan 8th ed Pg 81,91
118. Ans. 4, Harrison 17th ed Pg 836
Given the prominence of cross infection, hand hygiene is the single
most important preventive measure in hospitals
119. Ans. 1, Ananthanarayan 8th ed Pg 406 table (46.1)
120. Ans. 3, Harrison 17thed Pg 1282
C. neoformans is the leading infections cause of meningitis in
patients with AIDS
121. Ans. 1, Ananthnarayan 8th ed Pg 576
P-24 antigen is the earliest virus marker to appear in blood and is
the one tested for. It may be detectable in blood after about 2 weeks.
Test Positive after infection
Nucleic acid test 12 days
P-24 antigen test 10 days
Antibodies test 22 days
122. Ans. 1, Ananthanarayan 8th ed Pg 439-440
Normally in transcription there is formation of RNA for DNA.
Obviously, as the name suggests, reverse transcriptase will cause
transcription in reverse fashion i.e synthesis of DNA from RNA. Then
fresh RNA is formed from DNA. Amongst the given options, only
adenovirus is a DNA virus. All other are RNA viruses. Reverse
transcriptase induces formation of DNA from RNA. So it can be used
in the diagnosis of RNA viruses only.
123. Ans. 1, Ananthnarayan 8thed Pg 581
124. Ans. 3, Ananthnarayana 8th ed Pg 544-545
HBs Ag (+) ve and IgM anti HBc (+) ve indicates acute HBV
infection, which is a contraindication of blood transfusion.
 Option A: Anti HBsAg antibody may be (+) ve either after
immunization or after recovery from HBV infection. In both the
conditions, blood can be transfused.
 Option B: When anti HBe is (+) ve blood can be transfused if
other markers of infection are also negative Eg. HBsAg HBV
DNA, IgM anti HBC.
125. Ans. 2, Harrison 17th ed Pg 1050 & 16th ed Pg 990
High grade fever, altered sensorium, sign of hemorrhagic diathesis
(conjunctival hemorrhage) along with raised BUN and serum
bilirubin are suggestive of Weils disease.
126. Ans. 1, Greenwood 16th ed Pg 324
In chronic brucellosis, IgM often may be absent and any IgG can be
demonstrated. The standard agglutination test mainly identifies the
IgM antibody, so it is often negative in chronic brucellosis.
30th Session AP PG – 11.06.2016
Microbiology
127. Ans. 3, Ananthanarayan 6th ed Pg 263, 293
No enterotoxin has been identified with vibrio parahemolyticus. The
vibrio is believed to cause enteritis by invasion of the intestinal
epithelium.
128. Ans. 2, Ananthnarayan 6th ed Pg 27
For determining the efficacy of moist heat sterilisation, spores of
Bacillus stearothermophilus are used as the test organism.
 This is a thermophilic organism with an optimum growth
temperature of 55-60o C and its spores require an exposure of
12 minutes at 121 o C to be killed.
 Paper strips impregnated with 106 spores are dried at room
temperature and placed in paper envelopes. These envelopes
are inserted in different parts of the load.
 After sterilisation, the strips are inoculated in to a suitable
recovering medium and incubated for sterility test at 55o C for
five days.
Different biological indicators are used for different sterilization
processes:
1. Endospores of Geobacillus Used for
stearothermophilus : (a) Steam sterilization
(AUTOCLAVE)
(b) Gas (plasma & ozone)
sterilization
(c) Liquid sterilization
2.Bacillus atropheus: Used for
(bacillus subtilis var niger) (a) Ethylene oxide
(b) Dry heat sterilization
129. Ans. 4, Harrison 17th ed Pg 999, 916/ Ananthanarayan 7th ed
Pg 230
All the strains are highly sensitive to penicillin
 Penicillin is ineffective in treatment of gonorrhoea as most of
the strains are resistant to penicillin because penicillinase
producing N.gonorrhoeae (PPNG) have spread widely.
 Ceftriaxone is the drug of choice for gonococcal infections
130. Ans. 3, Ananthanarayan 8th ed Pg 198
The toxin is relatively heat stable, resisting 100 degrees for 10
to 40 minutes. Even if the bacteria are killed by warming, the heat
stable toxin is not destroyed.
131. Ans. 2, Ananthnarayan and paniker 7th ed Pg 299
Widal test is a tube agglutination test. S. typhi exhibits three well-
studied antigens:
 H or flagellar antigen are protein in nature and unique to S.
typhi.
 or somatic antigen are polysaccharide and more widely
distributed with in salmonella species than in S. typhi alone. O
antibodies rise first but, more importantly declines quickly after
the illness, perhaps because of their non -protein nature.
Though less specific than H antibody they serve as a good
index of recency.
 Vi or virulence antigen is capsular in nature and is found only
in recently isolated stains.
132. Ans. 1, Park 19th ed Pg 136
Carriers can be detected only by cultural methods. Swabs are taken
from nose and throat and it is examined by cultural methods for
diphtheria bacilli.
133. Ans. 3, Harrison 17th ed pg 1206
The segmented genome of rotavirus allows genetic reassortment
during coinfection a property that may play a role in viral evolution
and has been utilized in the development animal human rotavirus
based vaccines
134. Ans. 3, Ananthanarayan 8th ed pg 364
Lepra bacilli can multiply in the footpads of mice kept at low
temperature and this observation has become the standard
procedure for experimental work with the bacillus.
About other options:
 Incubation period of leprosy is 3-5 eyars
 INH is not an antileprotic drug.
 Leprosy vaccine
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Dental Pulse Academy Microbiology
 None of the candidate vaccines have yet attained as yet 141. Ans. 4, Ananthnarayan 6th ed Pg 23
vaccinehood Sterilization is a process by which an article, surface or medium is
freed of all microorganisms either in the vegetative or spore state.
BCG vaccine seems to protect against leprosy because of some
degree of antigenic relationship between lepra and tubercle bacilli. 142. Ans. 1, Ananthnarayan 8th ed Pg 489
But no vaccine can give life long immunity. Amongst the given options only Herpangina is caused by enterovirus
(Coxsackie group A) and the diagnosis is made by virus isolation
Candidate vaccines against M.leprae from the lesions or from feces. All other are respiratory viruses and
↓ ↓ are shed in respiratory secretions
Category 1 Category II
(based on M.leprae) (based on cultivable 143. Ans. 1, Ananthnarayan 8th ed Pg 575
mycobacteria) In developing countries, the most important pathogen is M.
tuberculosis.
 Killed M. leprae  BCG
 Killed m. leprae + BCG  BCG + M. vaccine 144. Ans. 4, Ananthnarayan 8th ed Pg 131
 Acetoacetylated M.leprae  Killed ICRC bacillus. Null cells are called so because they lack features of surface
markers of both B and T lymphocytes. They account for 5 to 10% of
135. Ans. 4, Harrison 17th ed pg 906 peripheral blood lymphocytes. They are also called large granular
Pathogenesis is due to exotoxin not endotoxin lymphocytes (LGL) as they contain large azurophilic cytoplasmic
Clostridium botulinum causes botulism not gas gangrene. granules. They proliferate in response to IL-2 and many LGL
Gas gangrene is caused by: express some lineage marker particularly CD-8, CD-2
 C. perfringens (80%)
145. Ans. 3, Parasitology by Chatterjee Pg 16, 25
 C. Septicum
There is no relation between dietary iron and invasive amoebiasis.
 C novyi The presence of erythrocytes in the cytoplasm is diagnostic of E.
 C.histolyticum histolytica as it is the only intestinal amoeba to exhibit this
characteristic.
There are two medically important spore forming bacteria, both of
them are gram positive Clostridia Bacillus. 146. Ans. 4, Cecil Essential of Medicine 5th ed pg 379
136. Ans. 3, Ananthanarayana 8th ed Pg 206,216
Option `a & `d can be excluded by following information in question:- 147. Ans. 1, CMDT 2006, Chapter 30 (general problems in
infectious disease)
 The isolated cocci are arranged in chains while staphylococci
are arranged in grape like clusters.  To fulfill the criteria for fever of unknown origin, a patient must
have had an illness of 3 weeks duration, Fever over 38.3
 The isolated organism is catalase negative while staphylococci
degree C on several occasions, and remain undiagnosed after
are catalase positive.
1 week of study in the hospital.
137. Ans. 3, Harrison 17th ed Pg 919, 916  Most cases represent unusual manifestations of common
Neisseria gonorrhoea has become resistant to numerous antibiotics diseases and not rare or exotic disease eg T.B., endocarditis,
because: gall bladder disease and HIV are more common causes of
 It has got remarkable capacity to alter its antigenic structure. pyrexia of unknown.
 It can easily adapt to changes in microenvironment.
148. Ans. 2, Harrison 17th ed Pg 296
Treatment for gonococcal infection: HACEK organisms are a group of fastidious, slow growing, gram
 For uncomplicated gonococcal infection ceftriaxone is drug of negative bacteria whose growth requires an atmosphere of carbon
choice (along with azithromycin or doxycyclin to cover dioxide. Species belonging to this group include: Haemophilus
chlamydial infection). species (mostly H. aphrophilus and H. para-influence),
Actinobacillus actinomycetemcomitans, Cardiobacterium hominis,
 For penicillin allegic patients quinolones are drug of choice.
Eikenella carrodens, and Kingella kingae
 Persons who cannot tolerate cephalosporin and quinolones,
spectinomycin is drug of choice HACEK bacteria normally reside in the oral cavity and have been
associated with local infections in the mouth. Beside mouth infection,
138. Ans. 3, Ananthanarayan 8th ed Pg 601
clinically most important infection caused by HACEK bacteria is
139. Ans. 4, Ghai 6th ed Pg 197 bacterial endocarditis, often in the setting of recent dental procedure.
Quadruple vaccine of DPT with H.influenza B is available in India but
conjugated vaccine (eg.HI b vaccine)does not interfere with 149. Ans. 3, Harrison 17th ed Pg 1050, 1051
immunogenicity of simultaneously given other vaccines. Leptospiral antibodies first appear in serum by end of first week, but
titre is not detectable. Antibodies titre reaches detectable levels in
140. Ans. 4, Ananthanarayan 8th ed Pg 244 the second week. A Leptospiral antibody usually peaks in the fourth-
VIRULENCE FACTORS OF ANTHRABACILLI fifth week.
1. Capsular polypeptide: 150. Ans. 2, Ananthanarayana 8th ed Pg 364
 Inhibits phagocytosis The bacilli are clumped together by a lipid-like substance, the glia;
 Encoded by a plasmid these masses are known as globi.In clinical material from
lepromatous patient they (lepra) bacilli are typically found within the
2. Anthrax toxin is a complex of three fractions: macrophages in dense clump. M. leprae are bound together by a
lipid like substance called Glia. Masses of bacilli are known as Globi.
(a) the edema factor (EF or factors 1)
Parallel row of bacilli in globi are called as Cigar bundle appearance.
 It is an adenyl cyclase, leading to intracellular accumulation of Globi are seen in virchows lepra cells or foamy cells which are large
Camp. undifferentiated histiocytes.
 Responsible for the edema.

(b) the protective antigen factor (PA or factor II)

 binds to the receptors on target cells
 antibody to PA is protective

(c) the lethal factor (LF or factor III)

 Causes of cell death
 Mechanism is not known
 Anthrax toxin is encoded by a separate plasmid.

30th Session AP PG – 11.06.2016 9